Effects of Fetal Programming on Osteoporosis

This chapter deals with the bone metabolic syndrome programmed by fetal nutritional deprivation, and the effect of compensatory growth from over-feeding in early life. The prophylaxis and treatment of the resulting conditions of osteoporosis and osteopenia are complex processes and depend on multi-professional cooperation. Aspects of nutrition-dependant embryogenesis are discussed, together with the need for hormonal, vitamin and mineral supplementation in cases of pathological osteogenesis. Clinical examples are presented of nutritionally-deprived pregnant women during World War Two and the late effects of intrauterine malnutrition on the bone quality of their offspring. In addition, one case suggestive of transgenerational transfer is presented, with a woman who had been nutritionally deprived as a fetus later having a son who in early middle age began showing typical signs of fetal nutritional deprivation even though his own intrauterine nutrition had been normal. The public health issue of fetal nutrition and bone quality in peoples migrating from famine-affected backgrounds to developed countries is also raised.